Defra liaised with the Scientific Advisory Committee on Nutrition regarding nutrition and emergency planning in 2024, resulting in an item at the committee’s 20 June 2024 meeting. Defra has continued to be in contact with the Department of Health and Social Care and the Subgroup on Maternal and Child Nutrition in following years to enable consideration of infant feeding and nutrition to support planning for food supply disruptions.

The Scientific Advisory Committee on Nutrition (SACN) is currently conducting a rapid review of whether current vitamin D recommendations for vitamin D intake and status are adequate for people with higher melanin concentrations. The vitamin D working group is reviewing relevant evidence and discussions are ongoing. In line with the usual SACN process, minutes of the SACN vitamin D working group meetings, along with minutes of all SACN meetings, are published on the SACN’s website. The SACN aims to publish conclusions of the review later in 2026. Ministers are informed of SACN publications and risk assessments and receive separate advice on potential subsequent policy options.

For people at risk of not receiving enough vitamin D during the summer months we recommend they consider taking a daily supplement containing 10 micrograms of vitamin D throughout the year. Advice is available on the National Health Service website for everyone, including pregnant and breastfeeding women, to consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter. Our focus is on ensuring that vitamin D policy prioritises interventions with the greatest public health impact. We have therefore not assessed the merits of workplace-based vitamin supplementation programmes and are not currently planning any additional action to introduce targeted vitamin D supplementation programmes. Any further risk management approaches will be considered once SACN has completed reviewing the evidence and made recommendations for people with higher melanin concentrations.

The National Diet and Nutrition Survey is designed to provide data on the diet and nutrition of the general United Kingdom population. The survey design means that oversampling of ethnic minority groups is challenging. However, a recent increase in the number of blood samples collected annually in the survey means we expect to be able to analyse and report vitamin D status by ethnicity by combining data collected from 2024 to 2029.

The Scientific Advisory Committee on Nutrition (SACN) is currently conducting a rapid review of whether current vitamin D recommendations for vitamin D intake and status are adequate for people with higher melanin concentrations. The vitamin D working group is reviewing relevant evidence and discussions are ongoing. In line with the usual SACN process, minutes of the SACN vitamin D working group meetings, along with minutes of all SACN meetings, are published on the SACN’s website. The SACN aims to publish conclusions of the review later in 2026. Ministers are informed of SACN publications and risk assessments and receive separate advice on potential subsequent policy options.

For people at risk of not receiving enough vitamin D during the summer months we recommend they consider taking a daily supplement containing 10 micrograms of vitamin D throughout the year. Advice is available on the National Health Service website for everyone, including pregnant and breastfeeding women, to consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter. Our focus is on ensuring that vitamin D policy prioritises interventions with the greatest public health impact. We have therefore not assessed the merits of workplace-based vitamin supplementation programmes and are not currently planning any additional action to introduce targeted vitamin D supplementation programmes. Any further risk management approaches will be considered once SACN has completed reviewing the evidence and made recommendations for people with higher melanin concentrations.

The National Diet and Nutrition Survey is designed to provide data on the diet and nutrition of the general United Kingdom population. The survey design means that oversampling of ethnic minority groups is challenging. However, a recent increase in the number of blood samples collected annually in the survey means we expect to be able to analyse and report vitamin D status by ethnicity by combining data collected from 2024 to 2029.

In 2016, the Scientific Advisory Committee on Nutrition (SACN) published a robust assessment of the evidence on vitamin D and a wide range of health outcomes resulting in the current advice for everyone to take a 10 microgram, or 400 international units, daily supplement of vitamin D during the autumn and winter. This advice is particularly important for those with limited exposure to sunlight during the spring and summer, those with dark skin, and those who usually wear clothes that cover up most of their skin when outdoors. These groups are more at risk of not having enough vitamin D and these groups are advised to take a vitamin D supplement all year round. The SACN is currently carrying out a rapid review of the vitamin D requirements for people with higher melanin concentration.

Vitamin D intakes and status, the concentrations in the blood, are monitored through the UK National Diet and Nutrition Survey. Latest findings, from 2019 to 2023, showed that vitamin D intakes from diet and supplements were below recommendations and low vitamin D concentrations in the blood were found in 18% of adults aged 19 to 64 years old and 23% of children aged 11 to 18 years old. Analysis by ethnicity is not currently possible due to small sample sizes but will be considered in future years.

Government recommendations on vitamin D are promoted on the National Health Service webpage and through public-facing social marketing campaigns, namely Best Start in Life, Better Health, and Healthier Families. These channels help ensure that at-risk groups, as well as the general population, are aware of the importance of supplementation.

Targeted support is also available for families through Government’s Healthy Start scheme which encourages a healthy diet for pregnant women, babies, and young children under four years old from very low-income households. In January 2026, Healthy Start supported over 353,000 pregnant women and children aged under four years old.

Healthy Start beneficiaries are eligible for free Healthy Start Vitamins which include folic acid and vitamins C and D for pregnant and breast-feeding women, and vitamins A, C, and D for children.  The formulations are in line with recommendations from the Government’s independent SACN for supplements.

United Kingdom dietary recommendations are based on independent advice from the Scientific Advisory Committee on Nutrition (SACN). The SACN publishes minutes for all its meetings on its GOV.UK webpages.

On 9 October 2024, the SACN held a horizon scan meeting, at which the committee discussed the topic of processed foods and health. Papers for these meetings are available on the SACN webpage, at the following link:

https://app.box.com/s/yuxmdx4jfxmgxycjj08mc5hw51plu942

Draft minutes of this meeting will be published on the SACN webpage early in 2025. The SACN webpage is available at the following link:

https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition#sacn-meetings

The SACN is planning to publish an update review on processed foods and health in 2025.

Dietary recommendations for the United Kingdom are based on independent advice from the Scientific Advisory Committee on Nutrition (SACN).

In July 2023, the SACN published a position statement on processed foods and health, summarising a scoping review of the evidence on food processing and health. The SACN concluded that observed associations between ultra-processed foods and health are concerning, but it is unclear whether these foods are inherently unhealthy due to processing or due to their nutritional content. Given the SACN’s concerns, the committee agreed to consider the issue again at its horizon scan in October 2024. At the meeting, the SACN considered a draft update review on this topic which considers more recently published evidence. It also considered the draft update review at its meeting in November 2024. Papers for these meetings are available on the SACN’s webpages. The SACN is planning to publish the update review on processed foods in 2025.

The SACN has only a dietary risk assessment remit. The SACN is not involved in policy development, and therefore has not had discussions on policies to reduce consumption of processed foods.

The Scientific Advisory Committee on Nutrition (SACN) undertakes risk assessment activities in response to emerging evidence and/or views from other expert bodies; requests from the sponsoring departments; and/or horizon scanning. SACN last undertook horizon scanning at their meeting on 19 June 2018; the draft minutes of this meeting will be published on the SACN website by the end of July 2018.

Nutritional needs identified by SACN over the last five years are numerous and are included in individual reports and position statements published on the SACN website:

https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition#reports

There are no current plans to request advice from the Scientific Advisory Committee on Nutrition on how malnutrition in the general population can be tackled.

The National Diet and Nutrition Survey (NDNS) collects information on diet and nutrient intakes and nutritional status but does not assess the prevalence of malnutrition in the population. Malnutrition is a complex, multifactorial condition which develops over a period of time, and for which there is no single agreed medical definition. NDNS assesses an individual’s diet and nutritional status at a single point in time and cannot assess other factors associated with malnutrition such as weight loss, or malabsorption of nutrients due to disease. It is therefore not possible to classify individuals as malnourished solely from the data collected in NDNS.

Data from the National Diet and Nutrition Survey collected between 2008 and 2016 shows that nutrient intakes have changed relatively little over this period with the exception of free sugars and salt.

Mean intakes of free sugars for adults (19-64 years) and children (4-10 and 11-18 years) were significantly lower in 2014/16 than in 2008/10 though remained more than double the recommended maximum in all age groups. Mean salt intake in adults, assessed through urinary sodium surveys, was 11% lower in 2014 than in 2006 but also remained above the recommended maximum. Mean intakes of fibre in children were significantly lower in 2014/16 than in 2008/10 and were below the recommendation. There were no consistent trends in intakes of total or saturated fat, total carbohydrate, or for vitamins or minerals.

The Scientific Advisory Committee on Nutrition (SACN) undertakes a risk assessment to determine whether to revise its advice either because of a need identified through horizon scanning or at the request of government. The SACN undertakes all risk assessment in line with its framework for the evaluation of evidence. The SACN’s risk assessments take account of evidence on intake and need in relation to health outcomes considered to be of key public health concern.

The SACN undertakes nutritional risk assessment on a case by case basis in relation to need – this is usually either because of a need identified through horizon scanning or at the request of government. The SACN has no plans to develop specific additional advice on supplement use.

The SACN has made supplementation recommendations in relation to vitamin D and folic acid. Which are available at the following links:

https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report

https://www.gov.uk/government/publications/folic-acid-updated-sacn-recommendations

The Scientific Advisory Committee on Nutrition (SACN) undertakes a risk assessment to determine whether to revise its advice either because of a need identified through horizon scanning or at the request of government. The SACN undertakes all risk assessment in line with its framework for the evaluation of evidence. The SACN’s risk assessments take account of evidence on intake and need in relation to health outcomes considered to be of key public health concern.

The SACN undertakes nutritional risk assessment on a case by case basis in relation to need – this is usually either because of a need identified through horizon scanning or at the request of government. The SACN has no plans to develop specific additional advice on supplement use.

The SACN has made supplementation recommendations in relation to vitamin D and folic acid. Which are available at the following links:

https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report

https://www.gov.uk/government/publications/folic-acid-updated-sacn-recommendations

The Scientific Advisory Committee on Nutrition (SACN) undertakes a risk assessment to determine whether to revise its advice either because of a need identified through horizon scanning or at the request of government. The SACN undertakes all risk assessment in line with its framework for the evaluation of evidence. The SACN’s risk assessments take account of evidence on intake and need in relation to health outcomes considered to be of key public health concern.

The SACN undertakes nutritional risk assessment on a case by case basis in relation to need – this is usually either because of a need identified through horizon scanning or at the request of government. The SACN has no plans to develop specific additional advice on supplement use.

The SACN has made supplementation recommendations in relation to vitamin D and folic acid. Which are available at the following links:

https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report

https://www.gov.uk/government/publications/folic-acid-updated-sacn-recommendations

Public Health England advice on vitamin D supplements recognises that in spring and summer, the majority of the population get enough vitamin D through sunlight on the skin and a healthy, balanced diet. The advice from the Scientific Advisory Committee on Nutrition was unable to take account of skin synthesis of vitamin D.

During autumn and winter everyone will need to rely on dietary sources of vitamin D. Vitamin D intake and status is measured through the United Kingdom National Diet and Nutrition Survey rolling programme.

Clear advice to the public continues to be communicated via the NHS Choices website at the following link:

https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

The National Institute for Health and Care Excellence has produced guidance on increasing vitamin D supplement use among population groups at risk of vitamin D deficiency, which is available at the following link:

https://www.nice.org.uk/guidance/ph56

My Lords, the Government welcome the advice of the Scientific Advisory Committee on Nutrition, and I am aware of the noble Lord’s long-standing interest in this subject. This is a complex issue and Ministers are considering it carefully. The Government will set out their position in due course.

My Lords, as I said, this is a complex issue. Apart from the SACN’s view recommending mandatory fortification, we have to remember that, as it pointed out, it can agree to it only if there are restrictions on voluntary dietary fortification and voluntary restriction of folic acid in other products, such as breakfast cereals, whose manufacturers actively push the fact that they put folic acid in their products. It is important to ensure that there is no increase in the number of people with intakes above the recommended amount. On the letter, the Secretary of State replied as follows on 20 December:

“I fully understand your desire to proceed with mandatory fortification of flour with folic acid. I have therefore asked my officials to prepare advice that I will consider in the new year”.

Does the Minister accept that this is not a campaign for fortification but an attempt to cut by half the number of pregnancies affected by neural tube defects, which lead to substantial numbers of terminations and of births affected by lifelong serious disability? If our preventive healthcare is world class, how come the UK has twice the United States of America’s rate of such pregnancies? Have the Government yet replied to the letter of December last from the Scottish and Welsh Governments, supported by the Department of Health in Northern Ireland and the UK Chief Medical Officers, backing the advice from the scientific advisory committee and asking for urgent action?

My noble friend is right, but the United States adds it not only to white flour but to quite a lot of other products. It is voluntary from state to state. There has been an important study in the Republic of Ireland which I will tell noble Lords about very quickly so they do not shout “too long”. The Republic of Ireland was going to add folic acid to white flour when it was discovered that blood samples showed that high intakes of folic acid in Ireland were mainly due to the existing practice of voluntary fortification of various foods by the industry. The FSAI anticipated that folic acid food fortification would continue to increase due to health claims being authorised by food. They are likely to prompt more food businesses to fortify their products so that they can make a claim.

My Lords, does the Minister agree that the reason why the United States has a low instance of spina bifida is that it adds folic acid to food? It has not come to any harm yet, and it has been doing it for many years.

I do not disagree with anything that the noble Lord says, but that is why the Secretary of State has said that he is looking at this very carefully and will come back in the new year.